Schedule Now
Check My Bill
Pay My Bill

A Patient Who Cried

A father and a daughter holding their hands together.

Quick Summary

  • The author performed a routine full skin exam on Bob, whose daughter the author had diagnosed a decade earlier with Morphea.
  • The exam found a few suspicious moles but no skin cancers.
  • Bob requested removal of a painful, growing fatty skin deposit, and the nurse scheduled the procedure.
  • Before leaving, Bob became emotional and cried, thanking the author again for the accurate diagnosis and referral to Seattle Children’s Dermatology.
  • The referral led to weekly methotrexate shots for his daughter, which worked better than pills due to reflux-related vomiting, reminding the staff of the long-term impact of thorough care.

One routine Monday morning, I came into Examination Room 5 to perform a full skin exam on Bob, the father of a young former patient I treated a decade ago for Morphea – a skin hardening condition. Prior to beginning, Bob thanked me for diagnosing his daughter’s condition, and I expressed my appreciation for his gratitude.

During the exam, we discovered a few suspicious moles, but thankfully, no skin cancers were detected. Nevertheless, he did request the removal of a fatty skin deposit that had grown and become more painful, so my nurse scheduled him for that procedure.

At the conclusion of the appointment, I intended to rush out to see the next patient. However, before I could leave the examination room, Bob became noticeably emotional and began to cry, reiterating his thankfulness over my accurate diagnosis of his daughter’s condition. He also appreciated my referral to have his daughter treated at the Department of Dermatology at Seattle Children’s Hospital where she was put on methotrexate shots weekly (instead of pills, which she threw back up due to a reflux issue).

This appointment was a reminder to me and my staff that we must always do our best for our clients because of the possible long-term impact we can make in their lives.

FAQ - Frequently Asked Questions

What is morphea, and why is early diagnosis important?
Morphea is a localized form of scleroderma that causes patches of skin to harden and thicken, sometimes affecting deeper tissues. Early diagnosis matters because treatment can reduce inflammation and help limit long-term skin tightening, pigment changes, or loss of mobility if joints are involved. It’s also important to confirm the diagnosis, since several other conditions can mimic morphea.
A full-body skin exam is a head-to-toe check of your skin, scalp, nails, and hard-to-see areas to look for suspicious moles, growths, or rashes. The clinician may use a dermatoscope and will note any lesions that should be photographed, monitored, or biopsied. How often you need an exam depends on your personal and family history, number of moles, sun exposure, and past skin cancers—many people fall somewhere between annually and every few years.
We look at the ABCDE features (Asymmetry, Border, Color variation, Diameter, and Evolution) along with symptoms like itching, bleeding, or rapid change. Dermatoscopy can add important detail, but the key factor is change over time or a lesion that looks different from a patient’s “signature” pattern. If there’s meaningful concern, biopsy is the definitive way to rule out skin cancer.
Removal is usually considered when the lump is painful, growing quickly, limiting movement, repeatedly irritated, or cosmetically bothersome. Another reason to remove it is diagnostic uncertainty—if it doesn’t feel or behave like a typical lipoma, we may recommend excision or imaging. If it’s stable, painless, and clearly benign, observation is often reasonable.
Costs vary widely, but simple in-office removals often fall roughly in the $200–$1,500 range depending on the size and location. Pricing is driven by factors like procedure complexity, whether pathology is required, insurance coverage, and whether it’s done as an office procedure or in a surgical setting. Your clinic can usually give a more accurate estimate after examining the lesion and clarifying your insurance benefits.

Share:

Table of Contents

More Posts

Send Us A Message